Bangladesh is now Asia’s fifth and the world’s eight most populous country with an estimated population of about 162 million. The growth rate of the population has fallen from 3% per annum at the first five year plan (1973-78) to about 1.47% p.a. now. The population is expected to grow by another 40% by mid century, to 222 million, and finally stabilize around 240 million several decades after that.

The Government has recognized that a massive population forms an obstacle to economic development, and has developed the National Population Policy which seeks to reduce fertility to replacement level (RF) by 2015. This requires a further TFR decline of 0.5 children per couple. But even at replacement fertility, the country will be adding two million annually to the population, and many in the population field, feel that the decline needs to be greater, with a target of 1.0 below present fertility (i.e., to TFR 1.7), projected to have substantial benefits across many sectors. It will not fall any lower, so all future population growth will be determined entirely by the fertility level.

High rate of population growth and the resultant increase in population size impede the process of achieving the objectives in various sectors of the economy. Therefore, those ministries and agencies whose target population is affected by population growth would have to share the burden of responsibility of population control and family planning, in addition to the targeted interventions of Ministry of Health and Family Welfare (MOHFW). All these challenges are to be addressed through the interventions of other relevant ministries, in addition to the interventions within MOHFW’s jurisdiction.

The Family Planning (FP) Program implemented by Directorate General of Family Planning (DGFP) has built a nationwide community based FP service delivery system, relying primarily on non-clinical methods such as oral pills and condoms. The emphasis on short- and long-acting clinical methods, which was relatively high in the 1980s, has faded. The current pattern of temporary contraceptive use, with oral pill users close to 30% of all married couples, is reaching saturation (only two other developing countries exceed this proportion), but other individual methods do not even account for 10% each. With persistent early marriage and low fertility, many women have completed their childbearing by the mid-late twenties, leaving them with two decades of reproductive life to avoid unwanted pregnancies. However, the proportions of couples relying on long-acting or permanent FP methods (IUD, implants, male or female sterilization) remains very low (less than 15%). Diversified and mass scale FP services will need to be undertaken to bring back the tempo of 1980s and achieve the target of fertility to replacement level.

Provide better support: The high rate of around 50% discontinuation in the first year by new adopters can be halved to 25%, and contraceptive prevalence could be doubled, with necessary interventions to reduce discontinuation including better counseling on side effects, especially in the first six months of use; recruitment of additional Family Welfare Assistants to bring the ratio of couples to workers back to a manageable level around 500; providing FP supplies and other support including provision of Post Abortion Care (PAC) services from the static service point (Community Clinic-CC); adopting region specific different service approach and emphasizing greater role of NGOs and private sector for servicing the urban slum dwellers and hard to reach areas.

Promote and facilitate use of LAPM: With the clearly demonstrable need for a shift from short-term methods like oral pills to Long Acting and Permanent Methods (LAPM), the public sector will continue to play a major role in ensuring free or low cost provision of quality clinical services. In order that LAPM method plays a greater role in the FP program, security of stocks will be ensured. Simplification of routine procurement procedures, training to upgrade the skills of community level workers, filling vacant positions and new recruitments, will be practiced for ensuring FP services. Various incentive packages will also be practiced to increase use of LAPM.

Priority interventions of MOHFW to improve Population and FP services will include:

Promote delay in marriage and childbearing, use of FP before the first birth thus promoting birth spacing and limiting family size.

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If You wish to use the Product for any purpose other than Permitted Purposes, You must purchase a standard commercial license from Licensor.

The U.S. Government and others acting on its behalf, has a paid-up nonexclusive irrevocable worldwide license to reproduce, prepare derivative works and display publicly by or on behalf of the Government.

execute the Source Code for internal testing purposes for the Product,

modify the Source Code in conjunction with MSH as required for Your internal business purposes relating to use of the Product only, and

make an archival copy of the Source Code if permitted by MSH as is necessary for internal business purposes relating to the use of the Product only.

Any copy or partial copy of the Source Code must include Licensors notice of copyright and other restrictive legends contained on the Source Code provided by Licensor. If you are provided Source Code, You must safeguard the Source Code and all copies of the Source Code to ensure access and use only by Your authorized employees and Authorized Contractors (defined below) who have a need for access in connection with their services to You only. You understand and agree that the Licensor is not responsible for any modifications to the Product made by You or on Your behalf, or the outcome of the use of any modified Product. In the event Licensor is no longer providing support for the Product, you may, upon receipt of written approval from an authorized representative of MSH, make the Source Code available to Your authorized contractor who has signed and returned the form of NDA attached to this EULA to MSH (Authorized Contractor), solely as necessary for maintenance and modifications to the Product on Your behalf.

Because the Source Code is provided to You for Your internal use in connection with the SCMP Software Program only, You may not provide access to or a copy of all or part of the Source Code to any third party (other than an Authorized Contractor) without Licensors written consent. You have no rights to provide, sell, or distribute copies of the Source Code or any derivative works that incorporate any part thereof, to any third parties. You may not modify, enhance, translate, or otherwise change the Source Code, except as required for Your internal use of the SCMP Software Program.

Any modifications or derivative works that incorporate any code, designs, artwork, data, information, graphics, images, processes, inventions, techniques, materials, forms, reports, devices, or other content of the Source Code of the Product will be owned by Licensor.

4. Prohibited Use. You may not

use the Product for any purpose other than Permitted Purposes;

modify, reverse engineer, translate into another programming language, decompile or disassemble the Product or any portion of it, or attempt to engage in any of such activities;

make any modifications, or derivative works of the Product (except as permitted in Section 3, if applicable), transmit the Product or otherwise permit it to be accessible over a network, by telephone, electronically, or any other means, including but not limited to through the Internet or in the operation of a service bureau (other than as required by Your employees and Authorized Contractors in the performance of services permitted by this EULA for the Licensee);

remove, cover, or change any proprietary notices or markings on the Product or its components;

export the Product in violation of applicable export control laws.

5. Termination. This EULA will automatically terminate if You fail to comply with any material provision of this agreement, including, without limitation, attempt to use the Product or the Source Code for any purpose other than Permitted Purposes. Upon termination of this EULA, You must stop all use of the Product and destroy any backup or archival copy of the Product made pursuant to Section 2 and of the Source Code. Your obligations and Licensors rights under this EULA or relating to the Product and the Source Code, if applicable, shall survive the termination of this EULA for any reason.

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7. Third-Party Programs. The Product contains or is accompanied by a third-party product (Adobe Acrobat Reader), which is provided to You under terms and conditions that are different from this EULA. Any use of this third-party program identified will be subject to the terms and conditions of such other license agreement and the terms and conditions of this EULA shall not apply to such third-party programs except that the disclaimer of warranties and limitation of liabilities provisions contained in this EULA shall continue to apply with respect to such third-party programs.

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10. Support. Use of the Product does not provide a contract for support (technical or otherwise) from Management Sciences for Health, Inc. Such services must be defined and agreed to in a separate contractual agreement or document.

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12. General Provisions.

Severability: If a court finds any provision of this EULA invalid or unenforceable under any applicable law, such provision is, to that extent, deemed omitted, and the balance of this EULA will be enforceable in accordance with its own terms.

Integration; Amendment: This EULA expresses the complete understanding of the parties with respect to the subject matter and supersedes all prior oral and written agreements, representations, and understandings regarding such subject matter. This EULA may not be modified except by written amendment signed by both parties.

Waiver: The failure to exercise any right provided in this EULA shall not be a waiver of prior or subsequent rights.

Governing Law: This EULA shall be governed in accordance with the laws of the Commonwealth of Virginia of the United States, exclusive of its choice of law rules.

Jurisdiction: Licensee consents to the exclusive jurisdiction and venue of the federal and state courts located in the Commonwealth of Virginia in any action arising out of or relating to this EULA. Licensee waives any other venue to which it might be entitled by domicile or otherwise.

Successors and Assigns: This EULA shall bind each partys heirs, successors and assigns. Licensee may not assign or transfer its rights or obligations under this EULA without the prior written consent of Licensor. Any assignment or transfer in violation of this section shall be void.